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NDC-11 (Package) NDC-9 (Product) (Ascending) Generic Name Brand Name Strength SEER*Rx Category Major Class Minor Class Administration Route Package Effective Date Package Discontinuation Date Status
54868-3310-03 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3310-04 54868-3310 Leucovorin Calcium Leucovorin Calcium 5.0 mg/1 Ancillary Therapy Chemoprotective Antidote Oral April 15, 2002 In Use
54868-3344-00 54868-3344 Triamcinolone Hexacetonide Aristospan Hormonal Therapy Adrenal Glucocorticoid Corticosteroid July 12, 1994 June 30, 2011 No Longer Used
54868-3348-01 54868-3348 Medroxyprogesterone Acetate Depo-Provera 400.0 mg/mL Hormonal Therapy Progestin Intramuscular Jan. 13, 1995 In Use
54868-3613-00 54868-3613 Medroxyprogesterone Acetate Depo-Provera Hormonal Therapy Progestin Jan. 24, 2000 June 30, 2011 No Longer Used
54868-3623-00 54868-3623 Methylprednisolone Sodium Succinate Solu-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid April 16, 2013 June 30, 2010 No Longer Used
54868-3637-00 54868-3637 Methylprednisolone Sodium Succinate Solu-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid April 16, 2013 June 30, 2010 No Longer Used
54868-3637-01 54868-3637 Methylprednisolone Sodium Succinate Solu-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid April 16, 2013 June 30, 2010 No Longer Used
54868-3826-00 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-01 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-02 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-03 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-04 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-05 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-06 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-07 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-08 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3826-09 54868-3826 Methotrexate sodium Methotrexate Sodium 2.5 mg/1 Chemotherapy Antimetabolite Folic Acid Analog Oral Dec. 5, 2007 In Use
54868-3896-00 54868-3896 Methylprednisolone Acetate Depo-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Jan. 7, 1997 June 30, 2011 No Longer Used
54868-3896-01 54868-3896 Methylprednisolone Acetate Depo-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid May 3, 2005 June 30, 2012 No Longer Used
54868-3896-02 54868-3896 Methylprednisolone Acetate Depo-Medrol Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Jan. 7, 1997 June 30, 2011 No Longer Used
54868-3924-00 54868-3924 Hydrocortisone Cortef Hormonal Therapy Adrenal Glucocorticoid Corticosteroid Oral Dec. 15, 1952 June 30, 2001 No Longer Used
54868-4030-00 54868-4030 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Sept. 18, 2000 In Use
54868-4030-01 54868-4030 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Sept. 18, 2000 In Use
54868-4030-02 54868-4030 Estradiol Estradiol 1.0 mg/1 Hormonal Therapy Estrogen Oral Sept. 18, 2000 In Use

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